08 February 2012 5:24 PM

Antidepressants: do they heal or harm?

Antidepressants are prescribed by the billion. They are largely responsible for pharmaceutical companies being financial giants. But do they work? Do they actually help people to feel better and function more effectively?

Or do they suppress all feelings, the positive as well as the negative?

And might they even drive some people towards suicide, rather than protect them from it?

Even their title is a clinical confidence trick. Naming a drug an 'antidepressant' does not make it so.

The placebo effect, convincing patients purely through the name rather than through any active pharmacological constituent, is substantial. Large scale meta analysis of clinical trials on antidepressants have found them to be only ten percent more effective than sugar tablets.

But there is an even greater indictment than this. So called 'antidepressants' are sometimes the chosen drugs of overdose in suicide. They have little effect in curing but they do have a dreadful effect in killing.

The fundamental question that has to be asked - of the pharmaceutical industry and the medical profession - is why these drugs are prescribed at all.

The answer is deeper than the obvious 'for profit' or 'because doctors don't know what else to do'.

It is even more disturbing than the trite response 'because we are trying to help people who become overwhelmed by personal and social problems'.

The drug companies have been very successful in tackling physical illnesses affecting organs less complex than the brain. They seem to assume this success qualifies them to manipulate the function of our most delicate and precious possession - the human brain - as if they understood it. They don't. They really don't know the first thing about it, because nobody does.

What we do know is that there are more neuronal connections in one brain than there are stars in the galaxy. Further, in the mood centres of the brain, it has been estimated that there are many different neuro-transmitters, the chemical messengers that transfer impulses from one brain cell to another.

The pharmaceutical industry, and doctors by complicity, work primarily on four of these neurotransmitters: dopamine, serotonin, nor-adrenalin and gamma amino butyric acid. What we don't yet know is the effect of this chemical interference from antidepressants on the function of all the other neuro-transmitters.

As a former GP, I have always been a very reluctant prescriber or taker of medications. I respect the autonomy of the body's physiology: mostly it knows very well how to put itself right.

Currently, I take one drug to counter the effect of osteoporosis of the spine and another to counter the effects of an enlarged prostate gland. My mother had osteoporosis and my father had prostate problems.

They suffered: I do not. I simply take daily medicines and they work. But this pharmacological success has led, fatally, to the belief that magic chemical bullets can solve all life's problems.

When I was made bankrupt and lost the product of my entire professional life, I inevitably suffered any number of stress symptoms and signs. I took nothing. Everything resolved as my life gradually came together again.

When my wife suddenly died of a stroke after fifty years of close companionship, I felt desperate. Yet I took nothing. My natural sadness persists but I am now fully functional emotionally and physically. Despite the pain, I didn't need tablets to turn me round. I just needed time.

The fearful spiritual triple whammy of antidepressants is that they are usually unnecessary, relatively ineffective and possibly harmful.

They cannot solve personal or social difficulties. They have a similar effect to alcohol, which works on the same part of the brain. They may give the impression of omnipotence while actually impairing judgement.

Antidepressants can get in the way of the mind's natural healing processes. Reality has to be faced at some time if we are to have a life that is our own, without a chemical dependency.

Are antidepressants the 'Soma' of Aldous Huxley's 'Brave New World'?

In the current issue of 'Scientific American', there is a report on a study on mice who were made either stressed and depressed or addicted to cocaine.

The researchers found that cocaine use led to the same molecular changes in the nucleus accumbens, a reward region in the mood centres of the brain, as are found in mice prone to stress and depression.

This finding is highly significant if it is also true in humans. In effect it may indicate that cocaine and antidepressants are taken for the same reason. This explains why addicts feel depressed when they stop using drugs. And that leads them to relapse.

It also may indicate that, as with alcohol, antidepressants are addictive to people who have an addictive nature.

In these people, an involutional melancholia needs to be distinguished from sadness - the natural response to distressing events that heals in time. We need to be able to feel naturally sad if we are also to be able to feel genuine happiness.

Antidepressants work - in so far as they are effective at all - by dulling all human feelings. For some, this could be the respite they seek. But for others it could be a major contributory cause of the self destruction they are trying to prevent.

What other medication would ever be licensed or prescribed with such a fearful litany of very real concerns?

We need to know where the balance lies. The pharmaceutical industry and hard-pressed doctors must do the necessary research to find out the real benefits versus the real risks.

Specifically, how many people taking antidepressants actually benefit from taking them? And, even more importantly, how many people - as a result of taking them - are driven towards suicide?

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DR ROBERT LEFEVER

Dr Robert Lefever established the very first addiction treatment centre in the UK that offered rehabilitation to eating disorder patients, as well as to those with alcohol or drug problems. He was also the first to treat compulsive gambling, nicotine addiction and workaholism.
He identified 'Compulsive Helping', when people do too much for others and too little for themselves, as an addictive behaviour and he pioneered its treatment.
He has worked with over 5,000 addicts and their families in the last 25 years and, until recently, ran a busy private medical practice in South Kensington.
He has written twenty six books on various aspects of depressive illness and addictive behaviour.
He now provides intensive private one-to-one care for individuals and their families.

He has written twenty six books on various aspects of depressive illness and addictive behaviour.

He now uses his considerable experience to provide intensive private one-to-one care for individuals and their families.